Joe & Jerry Flew the Coop

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Identifier walsh_2015_s4_c2-2
Title Joe & Jerry Flew the Coop
Creator Lulu L. C. D. Bursztyn
Subject Bilateral Vision Loss; Retina; Lateral Geniculate; Magnetic Resonance Imaging; Encephalitis
History A previously healthy 13-year-old girl presented to a local hospital with fever and myalgia, followed oneday later by lethargy and vision loss. Past medical history was significant only for acne, for which shehad been treated with doxycycline 40 mg/day intermittently starting 2 months prior to symptomonset. In the emergency department, the patient was difficult to arouse. Within 24 hours of onset,arousal level spontaneously returned to normal, but vision was light perception in both eyes. Based onfundus examination, she was given a presumptive diagnosis of neuroretinitis and transferred to ourhospital. On our examination, visual acuity was light perception only in both eyes. Pupils measured7mm in dim illumination and constricted moderately to direct light. Ophthalmoscopy in both eyesrevealed nearly confluent, sharp-bordered ischemic retinal white patches in the posterior pole. Opticalcoherence tomography (OCT) showed inner retinal thickening and hyperreflectivity. Fluoresceinangiography (FA) revealed occlusion of multiple small arterioles in the areas of retinal whitening. Awide-field FA confirmed multifocal arteriolar occlusions posteriorly with minimal late leakage and noretinal vascular abnormalities in the periphery. Brain MRI demonstrated symmetric T2 hyperintensitieson FLAIR images in the region in both LGBs, and in the cerebellar vermis and dorsal midbrain. T2-weighted gradient echo images showed hypointensities with blooming in the LGBs, indicative ofhemorrhage. These lesions showed restricted diffusion. ESR was 46, CRP was 0.1 and the followinglabs were negative: cardiolipin antibody, anti-DsDNA, anti-SSb/anti-La, anti-Sm, anti-RNP, anti-scleroderma, anti-Jol, chromatin, ribosomal protein and centromere B. An additional test was performed.
Date 2015-02-22
Language eng
Format application/pdf
Type Text
Source 2015 North American Neuro-Ophthalmology Society Annual Meeting
Relation is Part of NANOS Annual Meeting Frank B. Walsh Sessions; 2015
Collection Neuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Holding Institution North American Neuro-Ophthalmology Association. NANOS Executive Office 5841 Cedar Lake Road, Suite 204, Minneapolis, MN 55416
Rights Management Copyright 2013. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
ARK ark:/87278/s6vh8kgs
Contributor Primary Leah N. Levi
Contributor Secondary Elizabeth M. Palkovacs
Setname ehsl_novel_fbw
ID 179307
Reference URL https://collections.lib.utah.edu/ark:/87278/s6vh8kgs